The Unwelcome Rise of PMS After Postpartum Depression

[Editor’s Note: James from the blog James and Jax is our guest today to share her experience with the ups and DOWNS of post- postpartum depression periods. I know well the roller coaster of which she speaks. -Katherine]

Thanks to pregnancy and breastfeeding, I hadn’t had my period in more than two-and-a-half years. When it finally returned in April, all hell broke loose. Well, actually it was about two weeks prior to the return of dear Aunt Flo that I started to spiral. (God, don’t you hate when women refer to their periods that way? I do. So sorry for that.)

For half of April, I pretty much hated (with a capital H) everybody except baby Jax. I took many, MANY bubble baths to escape into my own lovely scented little world. Thank goodness for locked bathroom doors. I drank wine many a night. I did what I had to do, but I had no idea why I was doing it. Oh, and the cramps during ovulation? Mother of God they were the worst EVER. At one point, I laid on my kitchen floor while making dinner and waited, frozen, for the pain to end, wondering if I had some kind of illness. I can’t even imagine what poor little Jax was thinking as I laid there gripping a spatula!

Then on a Friday, I got my first postpartum period. Yay! Sort of. At least there was a valid explanation for the hormonal roller coaster I’d spent the previous few weeks riding, as well as an end in sight! The cramps eased, too.

But then May’s hormonal roller coaster made April’s look like a kiddie ride. In May, around the time of ovulation (or, the beginning of the luteal phase), I experienced INTENSE anxiety and depression. This instantly took me back to my postpartum depression days. And being reminded of those days, of those feelings of loneliness, fear, anxiety, sadness for no good reason, guilt, and so on, just pulled me down even further.

See, in my opinion, there’s something almost worse than postpartum depression, and that’s being reminded of what PPD felt like and being afraid that you’re not exactly out of the woods yet despite having thought so for months. Or years. Or whatever. The fear of the return of the monster, in my opinion, was actually worse than the monster itself.

For two days in mid-May I felt exactly how I’d felt at my lowest when my son was a newborn. Add to those awful feelings the fear that I was starting all over again in my struggle and the despair that I couldn’t do it again. I was afraid to leave my house because I didn’t think I could handle even the slightest challenge from the world. I wanted to curl up into a little ball on the couch in an empty house with a ton of TV shows saved on the DVR—so many that I didn’t have to use my own brain for days until the fog lifted. I couldn’t concentrate. I couldn’t think clearly. I didn’t go to work. I just couldn’t. Yet I still had to be a mom. Fortunately, I had enough common sense to call my therapist (with whom I had recently “broken up”) and tell her what was happening.

She suggested that what I was experiencing could be severe PMS and that I make an appointment with my OB/GYN to discuss my symptoms. That night, I went to the OB/GYN and received a diagnosis of severe PMS and a prescription for Sarafem, which is Prozac that is used at a low dosage during only the luteal phase of the menstrual cycle.

The next day, I researched the compatibility of Sarafem with breastfeeding (I’d received mixed advice from several health care practitioners and a pharmacist about whether it is safe to use while breastfeeding) and concluded I prefer other non-pharmaceutical options. I’m the type of person who has greater anxiety at the thought of taking anti-anxiety meds. Not ideal, I know.

During my research, I received great advice from women I know via Twitter and other social media, as well as in real life, who have had a similar experience with their first few postpartum periods. Little did I know that it’s relatively common to experience such intense hormone-related mood swings during the first few postpartum periods. Why doesn’t anybody talk about this?

I vowed to eliminate caffeine from my morning routine, to decrease my sugar intake, and to add in some exercise and sunlight whenever possible. In addition, I trudged to the pharmacy to arm myself with omega 3s, calcium, vitamin D, a B complex, and some herbal tea. Those are some of the things I’d read (or had been told) could help alleviate the mood swings associated with severe PMS. I figured I’d give it a shot for a month and see how I felt, promising myself that if I didn’t feel much better, I’d fill the Sarafem prescription.

I’m happy to report that June was a much happier month, mood-wise. In fact, I didn’t even notice I’d ovulated. I got my period without any kind of warning whatsoever (that’s always fun)! I hadn’t spent the previous few weeks hating anybody. I hadn’t had a single anxiety attack since May. I’m feeling great. I don’t know whether any of this has to do with the cocktail of supplements I’ve been taking every day or if things have simply settled down, hormonally speaking, since I’ve had a few postpartum periods now. But I’m happy that I feel like myself again. I win!

Is it TMI (too much information) to be blogging about periods and ovulating? Maybe, but I think that if women were more open about our feelings and experiences, even when it comes to the physical stuff related to postpartum depression, we could all benefit.

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Katherine Stone is the creator of this blog, and the founder and executive director of Postpartum Progress. She has been named a WebMD Health Hero, one of the fiercest women in America by More magazine, and one of the 15 most influential patient advocates to follow. She is a survivor of postpartum OCD.

Wow, and I thought I was the only one with killer periods and PMS after PPD. Thank you so much for sharing your experience. About to have baby #2 and I feel so much more prepared to manage my post-birth experience which doesn’t end with treating PPD. As you know 🙂

After my PPD, I was diagnosed with PMDD (prior to pregnancy, I'd only had mild PMS). Until now, I hadn't heard anyone talk about going through soemthing similar. Although I had stopped breastfeeding at that point, I also went the more natural route instead of the two week per month anti-depressant routine. Vitamin D supplements and Evening Primrose were what my OB recommended and I must say they worked wonders. Thank you for sharing your story and letting us know we're not alone.

I am so glad you are talking about this i have been trying to convince my gp that my anxiety and my monthly cycle are working together and he has been telling me i am wrong but i know my body and i still believe i am right .I also had trouble with hormones as a teenager and had to go on meds.Your story gives me the confidence to keep looking down this route.I will give supplements a try and see where it takes me. Thanks Julie Meloury

Thank you thank you thank you! My first postpartum period after 19 months began YESTERDAY and I've been so worried that my hormones are taking over my brain again. I had horrible night time anxiety last week and if this makes sense- anxiety that my anxiety is "back." Sometimes you just have to read it in print or talk to a friend to give you the perspective and the common sense that you need to hear! So, your timing could not have been better. Thank you, and thank you for your work with this site… it is so helpful to me!

YES! Thank you for bringing this up… I literally was just talking to my husband and mom the other day about how all of a sudden I have had crazy PMS after years of being on the pill and then pregnancy and then PPOCD, PPA, etc… so interesting that it's a real issue for other women and not just me 🙂

Me too!! I am 2 plus yrs. postpartum and unfortunately still have issues around ovulation and for about a week before my period starts. I also had PMS prior to PPD, but it became much more severe after going through PPD. Almost like mini PPd episodes. Yay. It would take me right back month after month. I had my hormone levels tested several months back and am lacking pretty significantly in progesterone. The pill form of progesterone that was prescribed spiraled me into a depression within a few days. I listened to my body and decided to try the cream in a much smaller dose. Even smaller than is recommended on the box. My period issues have gotten so much better! I use Progest with Evening Primrose Oil made by Emerita. It's sold at natural food stores or online. Amazon sells it cheaper than my local natural store (about $20), so I will be ordering it before I run out of this time. I tried the progesterone cream without the Evening primrose Oil in it this last cycle (the store was out and I thought it was the same) and had a rough time this cycle. So it may be the Evening Primrose Oil that is helping the most. Anyway, one tube lasts me 3 cycles since I don't use much. It really has made a difference. Thank goodness! I was nervous about messing with my hormones, but I did my research and have been certain that something was out of whack all along. I am not going to give up until I find a solution. So far so good though. It's worth a shot. 🙂

I had severed PMS/PMDD before getting PPD/PPOCD, but hey, I thought that was what everyone experienced with their periods! I have always been (but did not always understand that I was) "hormonally challenged". My periods did bring me into a pretty bad state after the baby sometimes, and sometimes not. Since I have been diagnosed with BRCA I and am a cancer survivor, I decided to have my ovaries removed and I have to say that I kinda wish I had had them out a long time ago! I LOVE no ups and downs every month. Of course, this isn't recommended for women who don't have cancer lurking in their genes, but I am glad I did it and I also take hormones (estrogen, progesterone, and testosterone) and feel better now in my late forties than in my 20s and 30s.

Wow! Great timing. I am just going through my second cycle now (CD 67 and counting). Everything is wonky as hell. But this post could have come right from me – right down to the unbelievably awful ovulation pain last week! How very interesting. I feel so much better having read this. I always had PMS, but wow – this is not pleasant now. I am hoping by my 5th cycle in, things should normalize. That was the pattern after my first son, too. Except that with my first son, I had hormonal wonkiness the whole first year (got my period 12 months postpartum). It was not until about 18 months postpartum that I felt totally back to the old me. And that's about the time that my period was totally normal again. I am hoping that this time around, I'll be back to the old me around December. I'll hopefully have have about 5 cycles by then.

me too. week before it starts. milder symptoms come back. take some emergency meds sim to valium if I need. try to take supplements like others mentioned but find it hard to be consistent. I'm hoping as I get better and better these symptoms will improve too.

amen for sharing and for noticing that there is a lack of sharing – we NEED to be telling each other more than – you'll gain weight and get morning sickness- we need to share the truth … and lol @ aunt flo

I'm so thrilled to read your comments. (Well, not thrilled that so many of us are suffering, but happy we are talking about it.) I was so hesitant to talk about my period & hormones on the internet! But now I am glad I opened up. I have been feeling SO much better since starting all those supplements. I hope you ladies can find some relief, too. What Kristen wrote above about "miniPPD episodes" was spot on for me. It was like a sudden, scary relapse after months of feeling better.

I wonder if that is why I've been having such a hard time these past couple of weeks emotionally?? I too prefer to avoid medications and am looking into Omega 3 supplements. I hope we all feel better soon.

I definitely notice an increase in symptoms before my cycle starts. It is really scary to think and be reminded of all that pain of the past. It did get better for me though and I hope it does for you as well!

Both PMS and postnatal depression are common problems that I see in my clinical practice. However, sometimes, the "pms" is only the tip of the iceberg. What do I mean by this? When we look at your overall mood, it tends to depend on a number of factors….. 1 Your genetics….eg family history of anxiety n depression 2 Your personality eg are you a perfectionist or do you have a emotional personality? 3 Are there a lot of environmental stress in your life 4 Do you consume drugs or alcohol 5 And do have a physical illness eg sleep apnea, hypothyroidism, pms, menopause etc. What Iam trying to highlight here is that if you have a family history of depression and anxiety, plus a perfectionistic personality, and your "world" is not perfect as you are trying to adjust to your new parenthood, and you have hormonal flux with pms, then it is not difficult to understand that your "depressive or pms" symptoms will be much more pronounced. The above article hightlights "pms" can bring out more depressive and mood disturbances rather than the other way around. Hope I have not confused anyone…… Dr Vin Family Doctor Australia http://www.doyouhavedepression.blogspot.com

This is a little bit different, but a little bit the same. 🙂 I had PPD twice with my sons and I never experienced this, BUT then we adopted. I ended up suffering from post adoption depression and back on an antidepressant. Obviously, I was menstruating this whole time since I wasn't pregnant, but once I was off the medication again (and doing fine) then I started experiencing EXTREME PMS symptoms. It was exactly like what the rest of you have said, "a relapse" and it was horrifying and awful. It's gotten better with time and being aware of what's happening. I also started taking Omega 3 supplements and a B vitamin supplement as well as making sure that I'm taking really good care of myself at that time.

I have been experiencing the same thing. Right around ovulation i get anxiety and depression. I start to feel good again after that then a couple of days before my period is the worst. I get super emotional and the anxiety gets bad again. Im two years into ppd and each month is getting better and better. I keep reminding myself that when I do have more good days its only the hormone fluctuation that makes the nightmare of ppd days come back. I tried birhtcontrol pill but for some reason when I would get my period i would get extremely agitated with my antidepressant. Anyone ever get that?

I am so comforted to see this article and hear what you ladies are going through..because I thought it was just me! I had my 1 year old iud taken out because I thought it had to do with it. I was having hormone headaches and exaggerated ovulation symptoms and thought it was from my iud. Turns out that it is just this crazy post pregnancy PMS. It feels way too much like PPD for my liking. I'm taking quite a few herbs to treat PPD-related symptoms still (for maintenance, I guess) and every time my period is coming I doubt their strength. I could not feel more hormonal than I do this week before my period. I feel this surge of hormones and anxiety. Ugh!

Well, well said. Such a true statement. Years later if I get in a funk my first thought is "Is it back somehow?!"

"there's something almost worse than postpartum depression, and that's being reminded of what PPD felt like and being afraid that you're not exactly out of the woods yet despite having thought so for months. Or years. Or whatever. The fear of the return of the monster, in my opinion, was actually worse than the monster itself"

I was so thankful for my therapist who pieced together that my major lows after the PPD lifted all fell within a 10 day span of the beginning of my period. This went on for about four months and then lifted. It's awesome that you brought it up and women will learn about it.

I feel really grateful for this words. I have passed a really strong PND and after 10 months still recovering without any antidepressant. Had my periods back 4 months ago and PMS always seems to bring anxiety and fear back… So will arm with loads of supplements and strength… And feel alleviate its not only me and that I am not going mad. Just will add that you can also have always at finger tips some flower essences as rescue remedy! That really helped me out! Thank you so much Katherine!

This is a wonderful discovery! My name is ashley I’m 23 and I have a 3 year old daughter (let me rephrase that! )my husband would kill me if I said my daughter ! Anyway, I was nightteen when I decided I was “ready for motherhood”.put I had my daughter feb 2011 .by the days after haveing autumn .(also)! Might i add i was in fact a single 1st time mommy, liveing with my aunt &uncle who had never being pregnant before!and “with baby daddy in jail, lil too no help.I was diagnosed with severe post partum deppression.at our first well baby visit! I went through Zoloft up 150 mg of that .I noticed a change at first then it was back to battleing the monster. Then I was put on cymbalta. 50mg of that then to 75mg of that. Me being ashley I’m no fan of pharmacy pills unless I have the flu or etc.!

I so wish someone had thought to tell me that pms mood swings are sooo much worse after having a baby. mine is nearly 6 months old and im just about to have my second period since giving birth (tmi?). my husband works 24/7 so im left home with our girl. i used to love it but the past couple weeks have been so bad. she’s going thru yet another growth spurt and when she cries it takes a lot to calm her down. sometimes its all i can do not to shout at her and tell her off. i have to put her down and go in another room to sort myself out. and then when her daddy comes home i push him away if he tries to come near me. i feel so bad for him, he cant do a single thing right when im like this. im going docs tmro to see wat they can give me, i just want this part of the month to be over already 🙁

I know this post was a long time ago, but thank you. I just finished BF my 7 month old about 3 weeks ago and I’ve started having serious anxiety problems. This is my second child and I never experienced this with my first. I just got my first PP period tonight and finally am realizing I might not be going crazy. It’s been an awful 3 weeks. I realized that my harmone levels must be all over the place after stopping BF and now having my first PP period. I’m making an appt with my OB in hopes she can recommend some natural relief. That you for posting!!! This has really helped.

I know this article is old but have to thank you for writing it! I didn’t experience this (from what I remember) after baby 1 but after baby 2, BAM! About 14 mo PP when my periods came back in full force I thought I was losing my mind.

Roller coaster is an understatement. Cramping so sharp and painful I thought I literally may never walk again. And this is being handed to me while I’m supposed to be responsible for two little lives?! And who to talk to? My husband? psh!

Thank you internet. Glad to know I’m not alone. It’s disheartening though how in the dark these hormonal conditions are. Believe it’s really not shared as much as it should be, especially from our midwives/ob’s. Hormone issues sometimes years after childbirth leaves us to think we’re all in this alone and it would have been nice to have at least a warning.

I have been experiencing extreme anxiety and depression and just had my first real postpartum period last month. Thank God for this blog post because you’re completely right, no one talks about this and I thought I was going crazy! Literally bawling at my baby doubt his food on the floor, not a pretty sight on date night with my husband… Thank you for keeping it real!

“See, in my opinion, there’s something almost worse than postpartum depression, and that’s being reminded of what PPD felt like and being afraid that you’re not exactly out of the woods yet despite having thought so for months. Or years. Or whatever. The fear of the return of the monster, in my opinion, was actually worse than the monster itself.”

Thank goodness I’m not crazy. I just got my first period after 15 months of freedom and I hate EVERYBODY right now except my LO. My husband asked me what’s wrong yesterday and I screamed “I have PMS DEAL WITH IT!”. Combined with being at work I swore today was going to be the day I hurt someone.

Thank you everyone for sharing ur stories,im hvn a very bad time myself,I hv a nine year old and a two year old,I sufferd and stil suffer frm pnd frm hving my youngest daughter,I take anti phsycotics and anti depressive meds, and every month about a wk or two before my periods my symptoms frm pnd get very very bad. Now and again I hv good days but im always dreading every month because I knw its coming all over again, it gets to a point when I sometimes feel sucicidal,im so sick of it nw and get so angry that it keeps hapening,I get very anxious depressed,repeated negetive thoughts,my mind races and it jus gets unberable,and im like a demon to my family and friends,the hospital come and see me to my home and im trying to explain how bad I get wen my period is coming,and they cant pin point for some reason why it hapens,so im stil waiting to get the right help,im convinced and my mum is that im lacking in hormones,is anyone else out ther as bad as mine??? I would like to here their stories

Aine, I’m so sorry you’re going through this. I’ve heard from many moms that have additional issues around the time of their period. Getting the right professional help is key to recovery. I hope you can find a doctor who is knowledgable about PPD and reproductive issues and can get you on the right treatment plan. If you’d like to chat with more moms who are having similar experiences, you can join our free, private forum here: https://www.smartpatients.com/postpartumprogress

I found this by googling “PMS after pregnancy” and can definitely relate to what you’ve written. I spent this last weekend in the worst depression I’ve ever experienced and cried to my husband both nights over seemingly small things. I haven’t ever felt such a roller coaster of intense emotion in my life. Like you, it actually took me a little bit to connect what I was feeling to the time in my cycle. And I also found that the second cycle was definitely much worse than the first for some reason. Going to try the same remedies you are and hope for a less dramatic third cycle!

Thank you for writing this article. I had terrible PPD after both of my kids were born, and it was such a low point for me. I just got my period back and the anxiety, depression, etc. are back like when I had PPD, although not quite as severe. I definitely don’t want to go through all that again :(.

I’ve just started my second postpartum cycle after being on a huge rollercoaster the past few days. Anxiety, mood swings, fatigue, feeling fearful and overwhelmed… I’d had a gap of over two years thanks to still nursing, but hadn’t realized how bad PMS could get postpartum. I’ve also developed hypothyroidism postpartum which thrown into this mix doesn’t help. This article and people’s comments have been helpful to reassure me that I’m not actually going crazy. 🙂

Hi everyone!! I too am going through this. I had PPD with my first and I also had with my third (march 2 2015) I thought i was in the clear until my period started up again and now it is like PPD all over again. I was just prescribed Prozac so I started that today. I really hope it helps. The anxiety is the worse.

Nice read, it sounds just like me. Happy to know that things will go back to normal, and many women are not alone. I am three postpartum periods in and going through it now. It was worse in the beginning cause I didn’t know, but I started tracking and noticing the symptoms happen around ovulation so I fight myself to not get in the pms mode, cause I know it’s my hormones. The mind is strong, especially when u know what your up against. Damn measly hormones. Lol

Thank you so much for writing this article! I’ve been experiencing extreme pms during this second month of my period returning, and I thought I was just going crazy. I’ve never experienced anything like this, I just can’t seem to get a handle on any of my emotions but I’m so glad to hear that I’m not alone and there are things that can help. We shouldn’t be afraid to talk about this! Thanks again ❤️

I’m so glad you blogged about this. It makes total sense to me now why I was feeling the way I was a week ago – and got my first period post birth today. I was ready to take myself off to an institution! Hopefully it won’t be as bad next month, but if it is then at least I will understand it a bit better. Thank you x

This was such a relief to find, I thought I was falling into a deep depression again, but have been reassured I’m normal. It’s my second period following the birth of my third child. I was sterlised during my last c-section and this is the first time I haven’t been straight back on the mini-pill following childbirth. I also had much lower pp moods following this birth, so was feeling really anxious those feelings were returning. I’m hoping that my tears and feelings of dispair will now subside and I can stop worrying.

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Postpartum Progress exists to provide peer-to-peer support. The information on this site is for educational, advocacy purposes only. It is not intended to diagnose or treat any medical or psychological condition. Please consult your own health care provider for individual advice regarding your specific situation and needs.